Healthfirst

The Nursing Home Liaison provides administrative support to the Integrated Products (IP), Management Services Organizations (MSO) and the PHSP lines of business in enrollment and retention of Custodial Medicaid Eligibility. This includes, but is not limited to, coordinating with internal departments as well as the external Nursing Home agencies on submission and approval of Medicaid Applications. Ensuring the process and member experience is of high quality. The Nursing Home Liaison is expected to contribute creative solutions and take ownership of daily assignments to ensure seamless communication and systematic completion of routine and special projects.

Duties and Responsibilities:

• Conduct and coordinate monthly enrollments for permanently placed consumers enrolling in the Managed Long Term Care program.
• Provides administrative support to the Intake & Enrollment department by acting as liaison between Nursing Homes and our Care Management and Intake & Enrollment departments. Track the Custodial Care Medicaid Applications submitted to the LDSS/HRA for approval by maintaining daily reports.
• Conduct daily Nursing Home visits to follow-up with applications and inquiries. Monitors Medicaid Renewal time frames for members for each line of business.
• Prepares weekly summary reports for each line of business to show the status of the Custodial and Renewal process.
• Reports to management the progress of all applications during weekly meeting. |Identify and escalate with teams all immediate outstanding issues.
• Serves as a resource on Nursing Home Medicaid and other entitlement. Keeps up to date on Medicaid and other entitlement program issues and on changes in Medicaid/Medicare/HMO laws and shares information with Care Team Social Work and other Care Team members as appropriate.
• Coordinate a synchronized workflow while maintaining the integrity of confidential information about prospective enrollees, as well as proprietary business information in collaboration with staff in Marketing, Relationship Coordinators, Intake RN, Intake Coordinators, Care Management Teams and Team Leads.
• Weekly field visits to the Nursing Homes for follow up on institutional Medicaid Applications

Minimum Qualifications:

• High School Diploma or GED Equivalent
• Medicare, Medicaid, or Managed Care experience
• Previous training experience in Managed Long-Term Care and customer service setting
• Experience with servicing the frail adult or elderly population
• Ability to create a positive impression during first contact with prospective members by setting the tone and being able to immediately demonstrate product knowledge and credibility with the goal of maximizing the number of scheduled appointments to achieve daily, weekly, and monthly goals
• Understanding of and sensitivity to cultural differences and needs of the community are essential
• Adept at operating within a diverse and multi-cultural work environment and community of Members such as Spanish, Chinese, Russian, Creole and Korean
• Adept at working in an environment with fast-past changing priorities including high stress while achieving quota expectations
• Ability to maintain a calm, neutral disposition while managing many details in a distracting environment.

Hiring Range*:

• Greater New York City Area (NY, NJ, CT residents): $47,403 - $62,400

• All Other Locations (within approved locations): $41,101 - $60,320

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.